Observations on Health Care Reform

Between September 1966 and November 1982 my husband and I lived in Switzerland,with a brief sojourn of 3+ years in Germany. During those 16 years I birthed three babies and had one major surgery. We always had our choice of pediatrician and general practitioner. Two of my births, the first and the third, were in Switzerland. The middle birth was in Munich, Germany. The following comments will be reflections on the health care and insurances available to us in Switzerland. Granted these memories are more than 40 years old, but in all likelihood the same is true today.

In Switzerland health insurance is mandatory and affordable. Available options were private, semi-private, and public (government subsidized) insurances. At one time or another we had each of these. Our first insurance was semi-private. That means my first pregnancy was monitored by the OBGYN of our choice. He delivered our baby at the University Women's Hospital in Zurich. In Switzerland mother and newborn remain in the hospital a full week--and in our case, we had a semi-private room. For this insurance we paid a modest monthly premium. When we left the hospital we owed nothing. The care was thorough and first-rate.

After living in Munich, Germany we moved back to the Zurich area and chose private insurance. Our income had increased and we could afford the higher premiums that provided private rooms when hospitalized. During this time Thomas had minor out-patient surgery and the children had regular wellness checkups--all covered by the insurance.

When we moved to Basel, Switzerland in 1974 to work with a Swiss street mission we chose the public health insurance option because of affordability. Premiums were pro-rated according to income. With this option we could still choose our primary physicians and pediatrician, but my pregnancy was monitored with regular visits to the local clinic. Each time I saw the doctor on duty and was also closely monitored by a certified midwife. Due to complications with the pregnancy I was hospitalized two weeks prior to the birth and closely monitored. Delivery was at the Women's Hospital in Basel--and again, baby and mother stayed in the hospital for a week, this time in a private room! The care given me and and my complicated pregnancy was, again, excellent. And as before, we left the hospital owing noting.

My surgery six months later was fully covered by the Public health Insurance. With the three different insurances there was never any difference in the quality of care received. It is possible to have mandatory and affordable health insurance with multiple options.

For the last 27 years (since our return to the States) I have often said our United States health care system could learn from the Swiss system. But the comment is usually met with a stunned silence. I am puzzled at the resistance here in this country to learn from other countries, especially when they have a system that works well for everybody.